Hospital-Physician Relationships, Part 1

CEO Competence

In a previous blog, I described a book I co-authored with James Hawkins, now President of Professional Consulting Services “Sailing the Seven Seas of Hospital-Physician Relationships: Competence, Convenience, Clarity. Continuity, Competition, Control, Cash (Practice Support Resources, Inc, 2006).

Here is a recent review of the book:

Author: James A. Hawkins, MBA, and Richard L. Reece, MD
Publisher: PSR Publications, Independence, MO, © 2006
ISBN: 0-9759956-9-3

Reviewer:

A. F. Al-Assaf, MD, FAAMA
Associate Dean and Professor
Co-Director, Executive Healthcare Training Academy
College of Public Health
University of Oklahoma Health Sciences Center
Oklahoma City, OK

This short and practical book is intended for use by healthcare practitioners working in or intending to work in hospitals. It is full of tips and anecdotes on ways to nurture positive relationships between hospitals and physicians. It also identifies potential problem areas with advice on how to avoid and manage them.

The book describes seven (and a bonus eighth) issues all starting with a the letter "c" that enable physicians and hospitals to strengthen their relationship, encourage positive dialogue, and understanding. The seven c’s discussed are “competence”, “convenience”, “clarity”, “continuity”, “competition”, “control”, and “cash”. The authors also address another issue, “consumer-driven healthcare connections”.

This book shows you, the healthcare professional at both sides of the relationship, how to apply all of these mechanisms and techniques in your everyday practice to achieve the desired outcome of a harmonious and symbiotic relationship. Each of these issues is discussed in detail with several examples and explanations, including how each should be applied in a healthcare setting, how each is perceived by both physicians and administrators, and the benefits of implementing each. Each chapter (or issue) is concluded with a list of “take away questions" that sum up the chapter and provide some tips on implementation.


Jim Hawkins, a former hospital CEO and now health care consultant, is the lead author. His writings comprise 80% of the book. We set up the book in a point/counterpoint format. Jim makes the point: I respond. In the next seven blogs, I will excerpt my response to Jim’s points about CEO competence, convenience, clarity, continuity, competition control, and cash. You will have to read the book to see what I’m responding to. Jim, as always, speaks for himself – clearly, directly, and with verve.

Hospital CEO Competence – Physician’s Response

More hospital CEOs will lose their jobs over bad physician relations than any other single reason. Physicians will question your competence for the job. As a hospital CEO, how do you know if physicians consider you “competent”? To answer this tricky question, you need to know how physicians form their personal and subjective judgments.

These factors will shape these judgments.

• In the first place, if your hospital is doing well financially and you’re able to provide equipment or services to bolster the physician’s performance, you’re likely to be considered competent.
• In these days of hospital arms races, hospital financial performance depends on specialists’ performance within the hospital setting, for specialists’ in-house work contributes as much as 90 percent of the hospital’s bottom line.
• It’s important for a hospital CEO, not his or her underlings, to spend business and social time with specialist leaders asking such questions as “How can I make your work more productive?” “How can we work together for our mutual benefit? What irritates you about our hospital?” “What could we do better?” “What could we do in an outpatient environment that builds on our strengths as a brand name with marketing and financial resources and your clinical strengths?

Some clues: If the specialist brings his own nurse to assist at operations that may be a sign he considers your hospital stewardship incompetent. If specialists complain about being bumped or delayed in operating times due to lengthy “turnaround time” in the OR, and no action is taken, you may have a competence perception problem. If specialists build and finance their own ambulatory surgical center without consulting you, you’re on shaky grounds. If you don’t bring specialists into the planning of a hospital expansion, particularly an operating suite expansion, you’re inviting competency questions